Ketorolac (ophthalmic)

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Contents

[edit] BRAND NAMES

[edit] STRUCTURE

Ketorolac.jpg

[edit] MECHANISM OF ACTION

Ketorolac Ophthalmic Solution is a nonsteroidal anti-inflammatory drug which, when administered systemically, has demonstrated analgesic, antiinflammatory,and anti-pyretic activity. The mechanism of its action is thought to be due to its ability to inhibit prostaglandin biosynthesis. Prostaglandins have been shown in many animal models to be mediators of certain kinds of intraocular inflammation.

[edit] INDICATIONS

  • Ketorolac Tromethamine Ophthalmic Solution, 0.4% is indicated for the reduction of ocular pain and burning/stinging following corneal refractive surgery.
  • Ketorolac Tromethamine Ophthalmic Solution, 0.5% is indicated for the temporary relief of ocular itching due to seasonal allergic conjunctivitis. Ketorolac
  • Ketorolac Tromethamine Ophthalmic Solution, 0.45% (Acuvail) and 0.5% are indicated for the treatment of postoperative inflammation in patients who have undergone cataract surgery.

[edit] DOSAGE

  • The recommended dose of Ketorolac Tromethamine Ophthalmic Solution, 0.4% is one drop four times a day in the operated eye as needed for pain and burning/stinging for up to 4 days following corneal refractive surgery
  • The recommended dose of Ketorolac Tromethamine Ophthalmic Solution 0.5% is one drop four times a day for relief of ocular itching due to seasonal allergic conjunctivitis.
  • For the treatment of postoperative inflammation in patients who have undergone cataract surgery, one drop of Ketorolac Tromethamine Ophthalmic Solution 0.45% (Acuvail) should be applied by the patient to the affected eye twice daily beginning 1 day prior to cataract surgery, and continued through the first 2 weeks of the postoperative period.

[edit] CONTRAINDICATIONS

  • Patients with previously demonstrated hypersensitivity to any of the ingredients in the formulation.

[edit] WARNINGS AND PRECAUTIONS

Delayed Healing

Topical nonsteroidal anti-inflammatory drugs (NSAIDs) may slow or delay healing. Topical corticosteroids are also known to slow or delay healing. Concomitant use of topical NSAIDs and topical steroids may increase the potential for healing problems.

Cross-Sensitivity or Hypersensitivity

There is the potential for cross-sensitivity to acetylsalicylic acid, phenylacetic acid derivatives, and other NSAIDs. There have been reports of bronchospasm or exacerbation of asthma associated with the use of ketorolac tromethamine ophthalmic solution in patients who either have a known hypersensitivity to aspirin/non-steroidal anti-inflammatory drugs, or a past medical history of asthma. Therefore, caution should be used when treating individuals who have previously exhibited sensitivities to these drugs.

Increased Bleeding Time

With some NSAIDs, there exists the potential for increased bleeding time due to interference with thrombocyte aggregation. There have been reports that ocularly applied nonsteroidal anti-inflammatory drugs may cause increased bleeding of ocular tissues (including hyphemas) in conjunction with ocular surgery. It is recommended that Ketorolac ophthalmic solution be used with caution in patients with known bleeding tendencies or who are receiving other medications, which may prolong bleeding time.

Corneal Effects

Use of topical NSAIDs may result in keratitis. In some susceptible patients, continued use of topical NSAIDs may result in epithelial breakdown, corneal thinning, corneal erosion, corneal ulceration, or corneal perforation. These events may be sight threatening. Patients with evidence of corneal epithelial breakdown should immediately discontinue use of topical NSAIDs and should be closely monitored for corneal health.

[edit] PREGNANCY AND LACTATION

  • Pregnancy Category C (US)
  • Nursing Mothers: Caution should be exercised when Ketorolac Ophthalmic Solution is administered to a nursing woman.

[edit] SIDE EFFECTS

The most frequent adverse events reported with the use of ketorolac tromethamine ophthalmic solutions have been transient stinging and burning on instillation. These events were reported by up to 40% of patients participating in these other clinical trials.

Other adverse events occurring approximately 1-10% of the time during treatment with ketorolac ophthalmic solution including allergic reactions, corneal edema, iritis, ocular inflammation, ocular irritation, superficial keratitis, and superficial ocular infections.

Other adverse events reported rarely with the use of ketorolac tromethamine ophthalmic solutions included corneal infiltrates, corneal ulcer, eye dryness, headaches, and visual disturbance (blurry vision).

[edit] RELATED LINKS

[edit] BIBLIOGRAPHY

[edit] REFERENCES

[[Category:Ophthalmic NSAIDs]]

Non-steroidal anti-inflammatory drugs (NSAIDs)
Non-selective (COX-1 and COX-2 inhibitors) Aceclofenac   Acetylsalicylic acid   Benzydamine   Diclofenac   Flurbiprofen   Ibuprofen   Indometacin   Ketoprofen   Ketorolac   Ketorolac   Lornoxicam   Mefenamic acid   Morniflumate   Nabumetone   Naproxen   Niflumic acid   Piroxicam   Tenoxicam
Relatively COX-2 selective Meloxicam   Nimesulide
COX-2 selective inhibitors (Coxibs) Celecoxib   Etoricoxib   Parecoxib
Ophthalmic NSAIDs Bromfenac (ophthalmic)   Diclofenac (ophthalmic)   Flurbiprofen (ophthalmic)   Ketorolac (ophthalmic)   Nepafenac (ophthalmic)
Veterinary use Carprofen   Deracoxib   Firocoxib   Mavacoxib   Robenacoxib